Capitol Hill Caught Up In Health Act's Sticky Situation

Now, among the sticky political situations surrounding the Affordable Care Act is one facing members of Congress themselves and also the people who work for them. When Congress passed the law in 2010, Republicans basically dared Democrats to include Congress and most congressional staff in the new marketplaces called exchanges. The idea was that Congress shouldn't subject the public to something that they wouldn't have for themselves. Democrats called the bluff and wrote into the law that beginning next January they would have to drop their current insurance and join Obamacare. It turns out that they left something out - something important - and now they are having some trouble fixing it. With us to sort this us is NPR's health policy correspondent Julie Rovner. Hey, Julie.

JULIE ROVNER, BYLINE: Hey, David.

GREENE: OK. So let's start back a bit. How do members of Congress and their staff currently get insurance?

ROVNER: Well, they get insurance the same way every federal worker does, through the nation's largest employer-sponsored health benefits program, the Federal Employee Health Benefits Plan, or FEHBP for short.

GREENE: Those great acronyms.

ROVNER: Yup. Under that plan, workers get to choose from a wide array of insurance plans and the federal government pays about 75 percent of the premium. The worker pays the other 25 percent. It's actually the structure on which the new health law exchanges are based.

GREENE: OK. So that system's in place for people on Capitol Hill. How is that supposed to change under the federal health law for congressmen and senators and all their staff?

ROVNER: Well, under the law, as it passed, most members of Congress and staff are only eligible for coverage in a health exchange, starting January 1, 2014. But the people who wrote the amendment forgot to make any provision for those members and their staff to take their 75 percent government premium contribution with them. So instead of making these federal workers like everyone else, it would instead put them at a huge disadvantage compared to everyone else in the exchange, because it's not at all clear that they'll be able to have that government contribution to take with them into the exchanges.

GREENE: OK. So they were used to having the federal government paying about 75 percent of their premiums and the problem here is they might not be able to have that money when they go to these exchanges, money that you and I would sort of have from our employers when we go to these exchanges.

ROVNER: That's right. And we don't know for sure because the Office of Personnel Management, which oversees the federal workforce and its health insurance hasn't yet said how it's going to interpret the law. So these members of Congress and their staff could, of course, end up facing huge insurance bills. And what worries Congress about this is that it could lead into a huge brain drain, where particularly the more senior staff would simply quit. You know, working for a member of Congress is already a hard job with long hours and not particularly great pay, at least compared to what they could be getting in the private sector. Seeing your insurance costs quadruple, which is what this would be, would be kind of the last straw for a lot of people.

GREENE: Wow. I mean knowing the poll numbers suggests Americans don't really love Congress right now. I can't imagine a whole lot of sympathy for a problem like this. But I mean this could be very serious for people who work on the Hill. What's being done to fix it?

ROVNER: Well, that depends who you talk to or what you read. The Capitol Hill newspaper Politico reported last week there were high-level, formerly secret negotiations going on to try to work out the problem. But of course that looks like Congress is trying to exempt itself from the health law. Republicans quickly piled on, accused Democrats of hypocrisy, trying to exempt themselves from the law after the fact. Senate Majority Leader Harry Reid said simply there are no talks going on and no effort to fix the problem, which kind of strains credulity, given how concerned a lot of people are about this. Meanwhile, over in the House, Democrats are at least saying they want to find a way to solve this so staff aren't put at a big disadvantage. But it's just one more source of anxiety in a health law rollout that seems to be growing them by the week.

GREENE: Amazing story, Julie. Thanks for talking to us about it. We'll see how they work that whole problem out on Capitol Hill. NPR's Julie Rovner covers health policy. Thanks, Julie.